Peripheral arterial disease: A Pain in the Leg

23rd Dec, 2013

In basic terms peripheral arterial disease means that there is not enough blood reaching your legs in order to make them work correctly. This results in a pain in the legs whenever you try to walk very far and this is because your legs require blood to perform movements. This article focuses on the latest research in order to look at the best treatments as well as give you some tips on what you can do to overcome this problem.

What is it

As mentioned peripheral arterial disease or PAD for short is where not enough blood reaches your legs to make them work properly. This is because the big blood vessels in your legs have become too narrow to allow the correct amount of blood to flow there. Unfortunately the narrow blood vessels do not let the blood that carries the nutrients and oxygen get to your legs in sufficient numbers and this deficit causes lots of pain when you walk. Treatment is absolutely critical in this condition because if you ignore it the problem will become worse and there is a very good chance that you may lose your leg or legs. The reason that these blood vessels become narrow is due to a process in medicine known as atherosclerosis. In simple terms this is where fat and cholesterol deposits form in the inside of these blood vessels and narrow them so that they become ineffective, kind of like when you have a blocked drain in the bathroom. These plaques can also break off to flow into your bloodstream where they can cause clots that give rise to a whole host of other problems. Generally having narrow blood vessels in your legs will also mean that you will have narrow blood vessels elsewhere in places such as your brain and heart and so it is vital that you take care of yourself and see your doctor. Having narrow arteries in these areas mean that you are at an increased risk of stroke or heart attack. Individuals at higher risk of suffering from PAD are men who are over the age of 50 that smoke and who have diabetes. Also being overweight, having high cholesterol, high blood pressure and not doing much exercise increase your risk greatly.

Symptoms:

It is hard to know if the blood vessels in your legs are narrow until you start to get symptoms and by this stage the disease is often at quite a late stage. This is the reason that prevention and being healthy is so important. As you PAD worsens you may start to get pain in your legs upon walking a certain distance. This distance is known as a claudication distance and usually when someone has walked this distance they will start to notice cramping and pain in the calf muscle, foot, thigh or buttock of the affected leg. This distance varies from person to person and as the disease becomes worse the distance lessons until eventually you may even get pain while resting. On your legs themselves you may notice that there are ulcers, bruises or cuts that will not heal no matter what you do and your feet may go a purple color. When you visit the doctor they will talk to you about your symptoms and then examine you by taking your blood pressure and looking for a pulse at different sited within your body.

Treatment:

There are many forms of treatment as well as certain things that you can do yourself in order to slow the progress and improve the symptoms of PAD. Certain medicines are very effective and one type is known as an anti-platelet medication. Platelets are the components within your blood that allow blood to clot and the job of these medications is to stop that from happening. You must be careful when on these medications as if you get a cut or scratch it may take longer to stop bleeding than in normal circumstances. Taking anti-platelet medicines have been shown to make you live longer if you suffer from PTSD and the most common medicines that are prescribed are aspirin, dipyridamole or clopidogrel.

Another form of medication that is useful is statins and these may stop your PAD from getting worse. These stop the body from producing cholesterol by inhibiting an important enzyme in the process of cholesterol formation. By doing this cholesterol is not formed as it usually would be and this means that it will be unable to deposit itself on the inside of your blood vessels making them narrower. There are two kinds of statins that are commonly prescribed, these are known as simvastatin and atorvastatin. Lots of research has been done and this shows that those on statins live longer and are less likely to have a heart attack or stroke than those who are not on statins. There are two other medicines that may help those with PAD walk for longer periods of time without pain. These medicines are known as cilostazol and the other is pentoxifylline, however these medicines have many side effects and will only be prescribed if absolutely necessary. If you have very severe PAD and are not a candidate for surgery then you will be able to take a medicine known as a prostaglandin and this may reduce pain and decrease your chances of amputation.

There are many things that you can do yourself to try and help out your PAD symptoms. One of the most important things is to do regular exercise at least three times every week. This will allow you to be able to walk further without getting pain in your legs. This works as exercise will improve the blood flow to your legs by dilating the blood vessels in your legs and help get the nutrients and oxygen that they require. You should not overdo the exercise and your doctor will be able to tell you how much and what kind of exercise is safe for you. You must absolutely stop smoking, as PAD will worsen with smoking. Not only this but smoking puts you at a higher risk of suffering from almost every disease known to man.

Surgery is an option in those with very severe disease and this involves making the narrow vessels wider or by bypassing the narrow vessels by implanting a new vessel graft. Surgery is very effective and may help you to walk further, however this is usually a temporary fix and will usually not benefit you for more than a few years. There are two main techniques of surgery and one is known as percutaneous transluminal angiography and this involves feeding a catheter into your vessels and using a balloon to dilate them. If this surgery is not possible then the surgeons may perform bypass surgery whereby they will take a small piece of vein from your leg and use it to bypass the blocked vessels.

Outcome:

It is hard to say what will happen to everyone as all people react differently to treatment and all people will have differing stages of the disease. Symptoms may stay the same, improve or get worse over time, however treatment will almost always help you. Those with PAD have a higher risk of other events such as a heart attack or stroke and some people may even need a leg amputation. Looking after you and living a healthy lifestyle is vital to avoid this condition.

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